MICHAEL E.MINGMD, MSCECARRIE ANN R.CUSACKMDSENAIT W.DYSONMDJACQUELINE M.JUNKINS-HOPKINSMDVINCENTLIUMD KARLA S.ROSENMANMD
The biopsy specimen revealed amorphous pink to gray material in the dermis, surrounded by lymphocytes and multinucleated foreign body–type giant cells, with no evidence of vasculitis or panniculitis. A von Kossa stain was negative for calcium. These microscopic findings were consistent with a diagnosis of a gouty tophus. Laboratory data revealed normal levels of serum calcium and phosphorus and an elevated level of uric acid (12.2 mg/dL [to convert to micromoles per liter, multiply by 59.485]; reference range, 2.6-7.5 mg/dL).
Diffuse Nodules in a Woman With Renal Failure—Diagnosis. Arch Dermatol. 2007;143(9):1201-1206. doi:10.1001/archderm.143.9.1201-g